Fleur De Lis Abdominoplasty for Patient with Atrial Fibrillation History?

Doctor Answers (6)

Fleur de Lis

August 12th, 2009

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Yes you can have any kind of abdominoplasty but the risks and benefits need to be outweighed. You would need to discuss this with your plastic surgeon as well as your cardiologist. Likely, you will be medium to high risk and would have to get your plastic surgeon involved with your cardiologist.

I dont know if you are on coumadin or blood thinners and that may be a problem as well.

Good luck, and remember this is elective, cosmetic surgery....you need to look at the risks very carefully. Likely your procedure should be done in a hospital, not a surgery center.

Fleur de lis abdominoplasty for patient with atrial fibrillation history

August 12th, 2009

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Interesting question.

The decision of having ANY elective surgery (vs. emergent sugery for a life threatening situation) should involve a careful weighing of risk and benefits.

Atrial fibrillation involves an ineffective pumping o the upper chambers of the heart with relative stagnation of the blood in them, promoting clotting. It is caused by suddenly having multiple areas in the upper chambers (atriae) which pulse the heart instead of one (sinus node). The result is a faster and very irregular heart rate which in some people needs to be slowed down. In others with poor heart function, the normal atrial "kick" of properly contracting atriae is essential and without it the heart literally backs up resulting in heart failure. Such patients require special medications and maybe even a special pacemaker.

Finally, there is a huge difference between a NEW ONSET atrial fibrillation (A fib) and a CHRONIC one. Cardiologists usually try to either medically or electrically turn A fib to a normal (sinus) heart rate in new onset cases. In chronic cases, you are usually treated with medications or a pacemaker. (Remember the trouble former VP Cheney was having with his A fib?).

A good consultation with a cardiologist is essential REGARDLESS of your having surgery or not. You should NOT consider having any elective surgery if doing so may risk your life. One component consideration, is the use of blood thinners with chronic Atrial fibrillation. We cannot operate safely on a patient who is constantly bleeding. On the other hand, stopping such medication may lead to clot formation in the atriae and the clots travelling to distant sites causing stroke and death. That is why you MUST get the right medical opinion.

Now that we covered the dark sides. I assure you that most anesthesiologists are very familiar with A fib patients and pacemakers and can make surgery in such patients as safe as possible,

Yes but...

August 11th, 2009

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You must get clearance by a cardiologist or internist frist. You will be at risk if you develop afib again, for reasons that a blood clot can form in the heart, flip off, and cause tissue injury down stream. This could cause serious injury, stroke, and even death. So careful medical management and coordination will be a must for you.

Personally, I don't care for this abdominoplasty technique due to the vertical scar, but it this is the only way to get the job done, so be it.

Tummy Tuck Pictures

Abdominoplasty with concurrent medical problems

August 11th, 2009

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This is a great question, and as long as the atrial fibrillation is well controlled on medication you should be okay. If you're taking blood thinners, you will most likely need to stop these at least 2 weeks before surgery. So, check with your cardiologist first before you do anything. Also, you may want to consider meeting with the anesthesiologist before surgery so the he/she is comfortable with giving you anesthesia. With your history, I would also recommend performing the surgery in a hospital in case your atrial fibrillation becomes a problem after surgery. Good luck!

Atrial fibrillation requires medical evaluation prior to surgery

August 11th, 2009

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Dr. Jejurikar has succinctly summarized some of the key issues.

Atrial fibrillation if stable and well controlled is less of a concern than somone who goes in and out. However, it is best to discuss this with your internist or cardiologist prior to considering elective surgery. There are some medications which may trigger the fibrillation and may need to be avoided during surgery.

Body contouring surgery with atrial fibrillation

August 11th, 2009

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Yes. If the atrial fibrillation is of a long-standing nature, and the patient is not taking blood thinners, atrial fibrillation is not a contraindication to abdominoplasty. If the atrial fibrillation just started, a work-up by an internist or cardiologist will be needed first to investigate the possible cause.

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